Our NHS ambulance service needs critical care.

I witnessed another episode yesterday to affirm to me that the NHS is buckling under the strain and pressure of increasing demand. It cannot carry on this way or it will become unsustainable. 

A 91 year old lady fell just outside our shop, almost directly in front of the entrance. She couldn't be moved in case of any injuries she may have had, so was made as comfortable as possible while still on the ground. One of our staff stayed with her as the ambulance was called. In spite of the sunshine, the lady had fallen in the shade and an increasingly chilly wind made it quite cold, so she was wrapped up with coats and blankets. You can imagine how concrete holds in the cold, but this amazing lady was quite stoic although in pain. In spite of three calls made to the ambulance service over intervals of time, it was almost five hours before even a paramedic arrived. 

It reiterated to me the pressure they must be under, after seeing this happen to Neil when his bowel perforated and he was in such agony last year. We waited for over four hours after calling for an ambulance and in the end cancelled it, and saw a doctor who got him admitted to hospital as an emergency. Neither of us blamed the NHS because we knew that there would have been a good reason why an ambulance hadn't arrived. Someone somewhere could have had life threatening injuries, a heart attack or worse. We know this from watching programmes like '24 hours in A&E', 'Inside the Ambulance' and such like. You watch the emergency telephone operators having to divert ambulances that are on their way to a person who has fallen to maybe someone who has been stabbed. Or they have to chose between a child who is injured and a person having a heart attack. Which one does the only available ambulance go to first? It must be the worst possible situation to have to be in....to chose who to send an ambulance to if you don't have enough resources? Literally it could be a life or death decision. 

We are incredibly lucky to have a free service such as the NHS, but just from these two episodes alone I can see that the pressure on it has escalated over the last year alone. Before this I cannot ever remember having to wait, or seeing someone else having to wait, for more than an hour or two at the most for an ambulance. There are a number of reasons that I can see for this happening. 
1. Hoax calls. People calling 999 for no other reason than they think it is funny to do so. The emergency services respond to any call for help. To make a hoax call to any emergency service is irresponsible and down right stupid. Calls are all recorded so anyone doing this should realise there is a hefty sentence when you are caught. I've also heard recently about a policeman who had to visit a child, a young child, at home and talk to her with her parents about the fact this little one was repeatedly making 999 calls. The calls could potentially have been blocking a line for someone who had a real emergency. The police visited the property because the parents did not consider it a serious matter. It is a serious matter!
2. We have an ever increasingly expanding population and there is not enough money to fund more services to cope with demand. As the increasing population ages too, sadly you get more illnesses, broken bones, dementia and so on. 'Care in the community' doesn't always work and so the ambulance service and hospitals are the first port of call for someone who potentially, years ago, would have been in a nursing home or a special mental health care unit. 
3. GPs are under just as much pressure, and sometimes people will call an ambulance rather than go and see their doctor or call 111. Potentially this can also cause services to be diverted to somewhere it didn't need to be. 
I could go on and add more, but it's easy to see how just a couple of reasons together can add to the pressure and waiting times. Lots of little episodes add up to one big blockage. 

I was worried about that 91 year old lady, just like I was frantic when Neil was in such pain. When you put your trust in our NHS and they cannot fulfil that call for help, it makes you wonder how the future of the service will go. The dedication of the amazing people who work for our emergency services is second to none. I am seriously grateful and in awe of what they do. To be under such pressure and stress day in day out is commendable in the extreme. But I feel that something will crack one day, maybe soon. I think that the majority of people really appreciate those services, and the people who work within them. I also feel that maybe it is time we start to pay for some services, even if it is just five pounds, though I suppose the difficulty is how would you collect that money if someone was ill or hurt? How would you collect it at all? In some countries you get no treatment until you provide a certificate of medical insurance. If we lost the NHS and our emergency services, this could be the way the future would be, with private firms running them. Would we want that? Would you want that? Maybe it's time we, the people, look at how we can help this amazing service to withstand the strain it is under. Someone must have the answer?

When to call an ambulance

Before you call for an ambulance, you need to assess the casualty. To do this, follow the steps of the Primary Survey** to see if they have any life-threatening or other serious conditions.

If the area isn’t safe for you to assess the casualty, then call an ambulance straight away. 

If someone’s condition is life-threatening or very serious, then call 999 or 112 for medical help.

If someone’s condition isn’t serious, then you need to decide if they need treatment or not, and what options there are – for example, to drive them to hospital, or to call their doctor’s surgery for medical advice.

**The Primary Survey is a quick way for you to find out if someone has any injuries or conditions which are life-threatening. If you follow each step methodically, you can identify each life-threatening condition and deal with it in order of priority.

Use the letters DR. ABC to remember the steps: Danger, Response, Airway, Breathing and Circulation.

You’ll need to go through the Primary Survey every time you help someone, and make sure you don’t get distracted by anything else.

http://www.sja.org.uk/sja/first-aid-advice/what-to-do-as-a-first-aider/do-you-need-an-ambulance.aspx